Background:Tumor lysis syndrome is a metabolic derangement which is seen in patients with malignancy and receiving drugs for cancer treatment. It can arise in children or older cancer patients and is considered life threatening. Anticancer drug therapy is most commonly used method to treat cancer. Aim: To investigate the role of electrolytes and vitamins (A, C and E) in cancer patients suffering from tumor lysis syndrome during anticancer therapy. Study design: Prospective clinical study Methods: The study enrolled fifty diagnosed patients of Tumor lysis syndrome.Informed consent was taken from patients.Twenty patients, clinically healthy, age and sex-matched were selected as a control in the present study. 5cc blood was withdrawn from enrolled cases. The obtained samples were centrifuged at the speed of 4000-5000rpm for 10-15 minutes to obtain serum. The levels of Electrolytes (Na+, K+), and Vitamins A, C, E were estimated. Results: Study showed elevated serum levels of sodium (Na+) (28.26) in comparison withcontrol normal persons (21.26) and this is significant statistically (0.02<0.05). Serum Potassium levels among Tumor lysis syndrome (TLS) cases was (13.26) as observed in normal controlled persons (14.26) and results were significant statistically (0.03<0.05). Vitamin A level in Tumor lysis syndrome(TLS) cases decreased outstandingly (102.20) in contrast to normal control study persons.(188.26) and this is significant statistically (0.026<0.05). The values for Vitamin E in Tumor lysis syndrome cases was (4.26) and in controlled normal individuals (7.26) and proved significant statistically (0.015<0.05). Conclusion: Present study showed inverse relationship between Vitamins and electrolytes in TLS. Increased level of electrolyte imbalances and decreased vitamin levels is the reason responsible for the development of tumor lysis syndrome. Keywords: TLS, Vit A, Vit C, Vit E, Na+,K+

Background: Diabetes Mellitus is one of the leading cause of morbidity and mortality globally. According to WHO there is a steady increase in the number of diabetic patients annually. Maintenance of good glycaemic control in type 2 diabetic patients typically becomes progressively more difficult as the duration of disease lengthens due to decline in the capacity of the pancreatic beta cells for glucose stimulated insulin release, in the presence of insulin resistance. This study is conducted to observe the effect of metformin and bromocriptine individually and sub-therapeutic doses of these drugs when used as a combination therapy. Objective: The objective of this study is to primarily investigate and then compare the antihyperglycemic effects of bromocriptine with metformin, also to see the combined effect of sub therapeutic doses of both these drugs. Methodology: Random allotment of 24 albino male rats was done in four groups. Group 1 was kept as control. Alloxan monohydrate was given to group 2, 3 and 4 and diabetes was induced. Group 2 and 3 were treated with metformin (1.5mg/kg body weight) and bromocriptine (3 mg/kg body weight) respectively while group 4 was treated with sub therapeutic doses of metformin (1 mg/kg body weight) and bromocriptine (1.5 mg/kg body weight)both. Serum glucose levels were estimated at 1, 10, 20 and 30 days. Results: Results showed that metformin reduces blood glucose level significantly where as bromocriptine also showed reduction of blood glucose level but not as significantly as metformin. However, the combination of metformin and bromocriptine showed much reduction in blood glucose level than metformin and bromocriptine used alone. Conclusion: Bromocriptine and metformin when combined ameliorated blood guclose efficiently than given alone Keywords: Diabetes mellitus, bromocriptine, metformin

BACKGROUND & OBJECTIVE: There is scantiness of evidence-based knowledge of anti-viral therapy with sofosbuvir (SOF) and velpatasvir (VLP) in patients on maintenance haemodialysis. This report is an attempt to rationalise the safety and effectiveness of SOF and VLP in haemodialysis patients in Pakistan. METHODOLOGY: Twenty treatment-naïve patients were incorporated in this study. Patients on maintenance haemodialysis are being administered SOF and VLP. Before initiation of treatment, all necessary investigations such as viral load, liver fibro scan, genotyping and upper GI endoscopy were made. Patients received 400 mg/day and 100 mg/day dose of SOF and VLP, respectively. RESULTS: Mean age was 25 to 53 years; 30% were male and 70% were female as categorized. No one of these has clinical affirmation of progression of cirrhosis. The most prevalent genotype was genotype 4 that was found in 45% of cases and the second most evident was genotype 1 in 25% of cases and genotype 5 in 30% of cases. Time span of antiviral therapy was 12 weeks. CONCLUSION: SOF and VLP based direct antiviral agents were effectual, puissant and were aptly tolerated in patients on MHD. This drug combination was well tolerated in haemodialysis patients. Not a single patient discontinued this combination therapy due to severe complications.